Provider Demographics
NPI:1770226391
Name:BOVELL, LUZ MARIA (MSW)
Entity Type:Individual
Prefix:
First Name:LUZ
Middle Name:MARIA
Last Name:BOVELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9780 N 56TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-5546
Mailing Address - Country:US
Mailing Address - Phone:813-377-7260
Mailing Address - Fax:
Practice Address - Street 1:9780 N 56TH ST STE B
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-5546
Practice Address - Country:US
Practice Address - Phone:813-377-7260
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty